During the MUR it became apparent to me that he was in denial regarding his medication and really wished to be free of all of it. He had started jogging to improve his health and lose weight - which is admirable and I applauded this; but as he was now feeling fitter, he decided that he would stop his steroid inhaler and only use his blue inhaler when necessary. As he told me this I could hear his chest wheezing...
I explained the importance of regular steroid inhaler use to alleviate, and treat, his condition - and we discussed the idea of stepping down (and up) as conditions change; but in a sensible way - preferably with GP approval. He told me that the GP had previously given him similar advice - which he had ignored; but agreed to use the inhaler as prescribed in future after our discussions.
It's easy to be in denial; and in most cases probably occurs because people are ignorant of the consequences of benefit versus risk - good communication is so important.
Once a patient understands about the medication, patients are so much more compliant - and MURs are a great tool to get this information across and reinforce good messages!